The US Supreme Court issued their ruling today (June 28, 2012) on the constitutionally of the Federal healthcare reform law passed in 2010 (Patient Protection and Affordable Care Act of 2010) and its various parts. What does it say and where do we go from here? I offer short-term and longer term perspectives on next steps on this important matter.
In the short term, a 5-4 majority of justices upheld all key provisions of the Affordable Care Act of 2010 including the individual mandate. Though their ruling and the way they decided it will have implications on future Congressional action, in effect, the US Supreme Court affirmed its constitutionality and sent it back into the realm of our elected public policy makers to implement, execute and improve. For a concise, simple overview of what the US Supreme Court ruling said, see Health-Care Ruling: A Scorecard, from the Wall Street Journal’s Law Blog, http://blogs.wsj.com/law/2012/06/28/health-care-ruling-a-scorecard . For on-going legal analysis and other developments related to the Supreme Court’s ruling, see Scotus Blog – http://www.scotusblog.com/category/special-features/health-care
What I find far more informative and inspiring is the longer term look “up-stream” that leading stakeholders and experts committed to universal healthcare in the US are taking. This “up-stream” examination looks well beyond the immediate legal, policy and political discourse regarding the Affordable Care Act of 2010, to identify and develop a growing consensus around next steps in public policies and practices that will remake what we now think of as our US healthcare system. Their vision and action plan involves much more than is being discussed today by our elected policymakers and the media. As they see it, health is not just something that comes from the doctor’s office, it also is an outcome of addressing many community and neighborhood conditions that create an environment for healthy living.
The June 2012 Symposium sponsored by the Robert Woods Johnson Foundation (www.rwjf.org ) did a good job of capturing consensus from this group of leading stakeholders which include academic, business and government. In the Symposium’s Final Report, this diverse group of stakeholders conclude:
- “No matter how the Supreme Court rules on the Affordable Care Act, health care in the next 20 years will need leadership that embraces community needs and new roles to care and guide individuals across a more data-driven, accountable U.S. health system. That was a consensus reached by health leaders brought together this week by the Foundation for an intensive two-day symposium in Kansas City to explore the future of health and health care in 2032. Though the high court’s decision looms large, the Justices’ coming ruling was barely acknowledged by the diverse group of more than 50 leaders from across the national health spectrum. The group included clinicians, academics, entrepreneurs and business executives from employers that ranged from Google to IBM.”
- They see four “alternative futures” for what healthcare in the US may look like in 2032; 1.) Slow Reform, Better Health, 2) Health If You Can Get It, 3) Big Data, Big Health Gain and 4) The New Ethics of Health. Alternative future #1 they describe as resulting from a “Zone of Conventional Expectation”. Alternative future #2 arises from the “Zone of Growing Desperation”. Alternatives #3 and #4 arise in a “Zone of High Aspiration”.
The Symposium Report goes on to identify four key areas for focus that will help to advance a quality, efficient universal healthcare for all in the United States:
- Develop new health roles beyond just traditional medical care professionals and public health providers;
- Focus the health-tech sector on developing community health metrics;
- Cultivate new leadership for a healthy society; and
- Remove barriers to achieve better health outcomes and quality.
More on the Four Scenarios: http://debategraph.org/Poster.aspx?aID=77
 Health Leaders Look to 2032 for Opportunities to Improve the Health of the Nation at http://www.rwjf.org/newsroom/product.jsp?id=74533&cid=xfb_rwjf